Exam 3 (Oral Digestion, Deglutition, Gastric Motility) Flashcards
Term for “precipitate of food & saliva”
plaque
Tooth decay causes formation of _____.
plaque
_____ and ____ are produced by bacteria which demineralize enamel and attack protein matrix (tooth decay).
lactate
protease
What is the term for “demineralized enamel and attack of protein matrix”
cavities aka caries
What substance is in toothpaste that replaces OH groups on hydroxyapatite and kills bacteria?
fluoride
Lactic acid demineralizes enamel by dissolving _____ in tissue (teeth + bones).
CaPO4
What is known as the conditioned or learned reflex involved in oral digestion?
chew reflex
(T/F) Mastication is entirely voluntary.
False - mainly voluntary but has involuntary component
Stimulus of Chew Reflex
presence of food in mouth
Chew reflex (stimulates/inhibits) motor neurons of the jaw musculature.
inhibits
Chew reflex causes reflex (relaxation/contraction) of the jaw.
contraction
Clinical relevance to chew reflex
chewing/stretching jaw while intubating animal
Term for “combined secretions of paired salivary glands (parotid, sublingual, submandibular)”
saliva
2 secretory cell types of salivary glands
- parotid (serous - watery saliva)
- sublingual/submandibular (mucoserous - thicker)
(T/F) There is small tonic activity of saliva flow in most species between meals but the ruminant has high flow to buffer the rumen.
True
With meal intake, there is a large (increase/decrease) in salivation.
increase
Source of saliva
extracellular fluid volume
(Carnivores/herbivores/omnivores) has much greater saliva production/output due to their dietary niche.
herbivores
Match amount of saliva production to species:
Horse
Cattle
Dog
Man
10 gal/day
40 gal/day
0.5 qt/day
1.5 qt/day
Match osmolarity of ECF:
(300 mOsm/L | <300 | > 300)
isotonic
hypotonic
hypertonic
300
<300
>300
Saliva is used in clinical pathology testing to measure _____ in cattle.
heavy metals / chronic lead poisoning
What clinical signs are seen with lead poisoning in cattle? Why?
neurological signs, blue line near gums
drinks lead water –> lead combines with teeth plaque
In non-ruminants, saliva is (hypotonic/hypertonic/isotonic) at low salivary flow rates.
hypotonic
What are the main ions in saliva of non-ruminants? (4)
Na+
Cl-
HCO3-
K+
Saliva in non-ruminants (basic/acidic) at low flow rates.
acidic
The primary secretion of saliva is in the _____ of the salivary gland while the secretion is modified in the _____.
acini
duct
What transporters are used to modify saliva secretions in the salivary duct?
Na/H, Na/K, Na/Cl exchangers
K+ secretion
Saliva secretions are modified in the salivary duct only at (low/high) saliva rates.
low
If saliva is high flow rate and bypasses modifying transporters, the saliva at the end will be similar to __________ concentration.
extracellular fluid volume
What 3 ions are part of the primary salivary secretion at the acinus?
Na, Cl, HCO3
In ruminants, salivary flow is (hypotonic/hypertonic/isotonic) at all flow rates.
isotonic
In ruminants, salivary flow rate is (high/low) at resting flow rate and (higher/lower) when eating/ruminanting.
high
high
In ruminants, ____ is an important buffer in saliva at low flow rates and reciprocates with ____ at higher flow rates.
PO4-
HCO3-
Ruminant saliva gets closer to plasma concentration at (low/high) flow rates.
high
Ruminant saliva is (acidic/alkaline) with a pH of ____. For what purpose?
alkaline
8
buffers rumen pH (VFA)
Ruminants are constantly swallowing to neutralize _____.
VFA
pH of healthy rumen
6.5
What are the 4 organic components of saliva?
mucin
ptyalin
urea
bacteriocidal compounds
Ptyalin is a salivary ______ and only present in (carnivores/herbivores/omnivores).
amylase
omnivores
Ptyalin hydrolyzes ____ to _____ which is why bread gets sweeter as you chew.
starches
maltose
_____ is important in recycling of the ruminant and passively moves blood into the salivary duct.
urea
Urea is lipid (soluble/insoluble) and from ____ of the liver.
soluble
ammonia
What are 2 bacteriocidal compounds of saliva?
lysozymes (kill bacteria)
secretory antibody (IgA)
Why can licking wounds be beneficial?
secretory antibody (IgA) in saliva can kill some bacteria
What is an important source of nitrogen for bacteria of the microbiota needed for growth?
urea
Control of salivation is mainly ____.
neural (ANS - PSNS + SNS)
What kind of reflexes are in association with preparation for eating?
conditioned reflexes
Example of conditioned reflex
pavlov effect
What 3 types of input are a part of conditioned reflexes for control of salivation?
visual
auditory
olfactory
Unconditioned reflexes for salivation have a(n) _____ and _____ portion.
oral
abdominal
Stimulus for unconditioned reflexes (oral portion)
chemical + mechanical presence of food in mouth
What 2 receptors sense presence of food in mouth for unconditioned oral reflex for salivation?
tactile receptors
taste receptors
Unconditioned reflexes (abdominal portion) for salivation in most animals is associated with _____ stimuli.
noxious
(salivate when nauseous)
Why do you salivate when nauseous?
salivary center closely linked with vomiting center
3 receptor types in the unconditioned reflexes of salivation (abdominal portion)
esophageal
gastric
intestestinal
In the ruminants, ______ in the ____ (part of stomach) stimulates salivation - abdominal portion of unconditioned reflex.
fibrous material
cardia
(T/F) All glands receive PSNS & SNS nerves from the CNS.
True
What are the PSNS + SNS nerves for salivation from the CNS called?
salivary nuclei
Daily efferent output is a mixture of PSNS + SNS control but (PSNS/SNS) dominates fluid content while (PSNS/SNS) dominates releasing salivary enzymes/mucus.
PSNS
SNS
PSNS controls _____ of salivation.
SNS controls ___ and ___ of salivation.
fluidity
mucous + enzymes
Isolated effect of PSNS on saliva (2)
- copious watery saliva
- indirect vasodilation
Example of overdosing and having isolated effect of PSNS on saliva
overdose organophosphate insecticide
= down cholinesterase, up Ach = hypersalivation
In isolated effect of PSNS on salivation, indirect vasodilation occurs via _____ which leads to increased secretion and saliva flow.
bradykinin
Isolated effect of SNS on salivation (2)
- thick, mucus saliva (direct)
- vasoconstriction
Example cause of isolated SNS effect on salivation
aggressive/excitable dog –> thick mucousy saliva
In isolated effect of SNS on salivation, vasoconstriction occurs due to a _____ effect which decreases primary secretion.
alpha adrenergic
What hormone has a systemic influence on salivation?
aldosterone
Aldosterone increases is there is an increase in what 3 things?
- dehydration
- hemorrhage
- salt-deprivation
Four outcomes of aldosterone on distal salivary duct
- up Na+ reabsorption
- up K+ secretion
- down bloodflow to salivary gland
- down saliva output
Which species does aldosterone especially have an effect on in terms of salivation?
ruminants
What things increase to increase Na+ reabsorption via aldosterone?
Na+ & K+ channels
Na+ pumps
4 functions of saliva in all species
- soften/lubricates food
- oral hygiene
- dissolve chemicals (for taste)
- thirst sensation
In pigs + humans, _____ in saliva allows for starch digestion.
ptyalin
What special function does saliva offer to dog/cat that is not in other domestic mammals?
evaporate cooling (10x salivation rate)
What 2 special functions does saliva have for ruminants?
- buffers VFA (in rumen)
- recycles urea (nitrogen source)
Taste buds are ____ bodies composed of what?
ovoid
hair cells + unmyelinated sensory nerve endings
What 4 structures are taste buds distributed on?
epiglottis
palate
pharynx
tongue
5 tastes of humans
- salty
- sour
- sweet
- bitter
- umami (savory)
What tastes do we have high threshold for? Which is lowest?
salty/sweet
bitter
Why do we have a low threshold for bitter taste?
sense possible plant alkaloids (toxin)
Salt taste modality
Na+ (via Na+ channel + ENAC)
Sour taste modality
protons (organic acids)
Sweet taste modality
hexose
via Tas1r2/3 GPCRs
release ATP to afferent N
Which species have a loss of function mutation to sweet tastes?
carnivores (big cats, dolphins)
Example of sour organic acid
acetic acid
Bitter taste modality
organic cations
–> release ATP to afferent N
Example of organic cation for bitter taste
quinine
Savory/umami taste modality
glutamate receptor
–> release ATP to afferent N
What 3 tastes release ATP to afferent nerves?
sweet
bitter
savory/umami
Term for “ability to distinguish tastes/flavors”
taste acuity
(T/F) Taste acuity correlates with the number of taste receptors (taste buds).
False - does not correlate
3 influences on taste acuity
- stim. of taste receptors
- smell
- food temperature
Term for “drive to eat or drink”
nutritional widsom
4 drives for nutritional wisdom
- regulate energy intake
- water taste
- salt appetite
- other nutrients
What is the #1 drive to eat or drink?
regulation of energy intake
Term for abnormal appetite
pica
Term for swallowing
deglutition
Term for “common opening to trachea + esophagus”
oropharynx
Considering the oropharynx, you must be able to swallow without _____.
aspiration
Deglutition is a highly complex reflex requiring _____.
6 cranial nerves
3 main phases of swallowing (which are voluntary/involuntary?)
- oral phase (voluntary)
- pharyngeal phase (involuntary)
- esophageal phase (involuntary)
Steps of oral phase of deglutition
- food bolus forms
- positioned on back of tongue
- rostral tongue pressed to hard palate, jaw closes –> forces bolus into oropharynx
Steps of oral phase of deglutition
- food bolus forms
- positioned on back of tongue
- rostral tongue pressed to hard palate, jaw closes –> forces bolus into oropharynx
Function of pharyngeal phase of deglutition
move bolus from oropharynx –> esophagus
Stimulus of pharyngeal phase of deglutition
bolus pushed by tongue –> oropharynx
Afferent impulses from pressure receptors in oropharynx go to ______ in the medulla/pons that coordinates response (pharyngeal phase of deglutition).
swallowing center
Efferent action of pharyngeal phase of deglutition
soft palate- constrictor Mm close off nasopharynx
During deglutition, airway opening is (open/closed) and ____ is inhibited for a second to prevent entry of food bolus.
closed
respiration
During deglutition, there is contraction of _____ and ____ Mm.
pharyngeal
laryngeal
3 actions that occur from contraction of pharyngeal + laryngeal Mm during deglutition
- larynx raises
- glottis closes
- epiglottis covers glottis
Contraction of _____ muscles propels bolus through ______ as it relaxes briefly.
pharyngeal Mm
upper esophageal sphincter (UES)
After bolus moves through UES, breathing resumes and the bolus entry into upper esophagus initiates ________.
involuntary esophageal phase
What 3 steps occur within the esophageal phase of deglutition?
- primary esophageal peristalsis
- secondary esophageal peristalsis
- tertiary esophageal peristalsis
During primary esophageal peristalsis, there is (relaxation/contraction) behind the bolus and (relaxation/contraction) in front of the bolus.
contraction
relaxation
Relaxation of _____ occurs after the bolus enters the body of the esophagus and remains open until _______ passes.
lower esophageal sphincter (LES)
ring of contraction
LES closes completely to prevent ____.
gastric reflux
(T/F) Secondary esophageal peristalsis always occurs after primary.
False - only if needed to clear bolus
What 2 things induce secondary esophageal peristalsis?
- uncleared bolus
- gastric content / reflux
In secondary esophageal peristalsis, afferent impulse originates from ______.
esophageal body at bolus (NOT UES!)
_____ esophageal peristalsis is in the _____ muscle portion of esophagus and acts (systemically/locally) via _____ nervous system.
tertiary
smooth
locally
esophageal enteric
Where should an orogastric feeding tube be placed? Why?
proximal to LES
so LES can open/close normally
Esophageal muscle in birds
all smooth muscle (gravity helps)
Esophageal muscle in humans/horses
2/3 skeletal, lower 1/3 smooth
Esophageal muscle in dog/cat
mostly skeletal (some smooth near LES)
Esophageal muscle in ruminants
short segments of smooth M (esophagus groove)
Esophageal muscle in rodents
all striated (highly controlled)
Peristaltic movement is highly coordinated in the esophagus due to central control from swallowing center which acts through ____.
vagi
(Extrinsic/Enteric) innervation dominates control of esophageal peristalsis.
extrinsic
Skeletal muscle esophagus neural control in order
swallow center –> GVE nerve (vagal motor N) –> skeletal M
Skeletal muscle neural control is by (SNS/PSNS) and at the ____ neuromuscular junction.
PSNS
nicotinic
For skeletal muscle esophagus, there is __ motor nerve fiber per __ skeletal M fiber which means (little/lots of) control.
1
1
lots of
Name for striated muscle disease and disease example
Vagotomy
myasthenia gravis (autoimmune attach motor endplates for NMJs = difficulty swallowing)
Disorder for esophageal amotility if vagus N is cut which causes “food packing”
megaesophagus
Smooth muscle esophagus/LES neural control order
swallow center –> vagal PS N –> intrinsic plexi –> effector neurons –> smooth muscle
Which type of muscle in the esophagus has serial contractions by coordination of the ENS?
smooth muscle / LES
Neural control of the smooth muscle esophagus coordinate with _____ ______ which affects (circular/longitudinal) M while inhibitory nerves relax (circular/longitudinal) M.
muscarinic cholerinergic
longitudinal
circular
If you cut both vagi, you will only have ____ esophageal waves.
tertiary
What is the main function of the lower esophageal sphincter (LES)?
prevent gastric reflux
relax during swallowing reflex
Lower esophageal sphincter is (relaxed/contracted) at rest and (relaxed/contracted) during swallow.
contracted
relaxed
During sustained contraction of LES at rest, (circular/longitudinal) smooth muscle via inhibitory nerves is (on/off). On the other hand, (circular/longitudinal) smooth muscle via cholinergic nerves is (on/off).
circular
off
longitudinal
on
When LES relaxes during swallow, inhibitory effectors are (on/off) while cholinergic effectors are (on/off).
on
off
In the LES, circular smooth muscle is known as ____ fibers while longitudinal is known as ____ fibers.
clasp
sling
After a meal, _______ is increased to help enhance contraction of LES to prevent reflux.
plasma gastrin
During interdigestive period, ____ are present at LES.
MMCs (migrating motor complexes)
What 4 anatomical components are present to help LES to reduce reflux?
- flutter valve (intraabd esophagus)
- diaphragm pinching
- esophagus enters stomach at angle
- excessive gastric mucosa (horse)
Why can’t horses vomit?
- more acute esophageal angle
- excessive cardia mucosa
- high LES tone (more smooth M)
Term for “failure of LES to open”
achalasia
2 motor functions of the simple stomach (oral/proximal part)
- receive ingested food
- accommodation (storage)
2 motor functions of simple stomach (distal part)
- mix/grind contents
- control propulsion
Gastric digestion involves the formation of ______ (liquid of dissolved food + HCL + pepsin).
acid chyme
During digestion, ingesta is formed into _______.
concentric spheres
The (first/last) eaten food is up against gastric mucosa while the (first/last) eaten is in the middle.
first
last
(T/F) In the proximal stomach, basic motility pattern is phasic, not tonic.
FALSE - tonic not phasic
What does it mean that the proximal stomach is tonic not phasic?
no peristalsis
tonic contractions as stomach empties
_______ smooth muscle layer dominates in tonic contractions of the proximal stomach and is (contracted/relaxed) during a meal.
circular
relaxed (for storage)
As the stomach empties, there is a(n) (increase/decrease) in circular smooth muscle tone in the proximal stomach.
increase (pushes content –> distal part)
What 2 processes allows the proximal stomach to receive and store food?
- receptive relaxation
- accommodation
Receptive relaxation of proximal stomach order of events
swallowing center –> vagus –> activated inhibitory effector neurons = relaxation of circular smooth muscle
During accommodation, tension in the stomach wall can increase significantly without an increase in ______.
intragastric pressure
Accommodation in proximal stomach order of events
gastric tension receptor –> CNS –> vagus –> activated inhibitory effector neurons = increase radius + tension
During accommodation in the proximal stomach, there is the same increase in ___ and ___, so there is the same _____ at the esophageal sphincter.
radius
tension
pressure
As the proximal stomach empties, accommodation (increases/decreases), inhibitory nerve action (increases/decreases), and circular smooth muscle contraction (increases/decreases). Why?
decreases
decreases
increases
forces residual content –> distal part
In the distal stomach, basic motility pattern is peristalsis driven by ______.
pacemaker
3 main functions of the distal stomach
- propulsion
- emptying
- retropulsion
What occurs during propulsion (of distal stomach)?
pylorus opens so content can go in
What occurs during emptying (of distal stomach)
pylorus is open
chyme exits
mixing + grinding
What occurs during retropulsion (of distal stomach)?
pylorus narrows
moves solid matter
Pigs are fed “fines” for fattening but decrease diet bulk which (increases/decreases) acid chyme and causes _____.
increases
proximal stomach ulcers
What is the “fed pattern” in distal stomach?
volume/presence of food –> stomach empties faster
What two things sense contents of food in the stomach?
mechanoreceptors
chemoreceptors
What 2 things mediate gastric motility/emptying in distal stomach?
- neural activity
- hormones (gastrin)
When mechanoreceptors + chemoreceptors sense food in stomach, they respond by (increase/decrease) motility in what 2 areas?
increase
stomach + colon
What 2 neural stimuli lead to release of gastrin?
cholinergic neurons
GRP (gastrin releasing peptide)
What 2 luminal stimuli lead to release of gastrin?
amino acids
increased pH (pH > 4)
Response to gastrin
increased gastric motility + emptying
What 2 things mediate feedback (inhibitory) control of gastric motility/emptying in distal stomach?
- enterogastric long reflex (neural)
- CCK + incretins (hormonal)
What 3 receptor types stimulate afferent pathway for feedback/inhibitory control of distal stomach motility?
- duodenal osmoreceptors
- duodenal pH receptors
- stretch receptors
Duodenal hypertonicity leads to (more/less) gastric emptying in distal stomach while hypotonicity leads to (more/less).
less
more
Why does duodenal hypertonicity cause less gastric emptying?
allow more time to dilute content in the duodenum
When duodenal pH is >3.5-4 there is (more/less) gastric emptying in the distal stomach. When pH is <3.5-4 there is (more/less) emptying.
more
less
Why is there less gastric emptying of the distal stomach when the duodenal pH is <3.5-4?
time to neutralize acid w/ bicarb secretion + pancreatic juice
When duodenum is full, there is (more/less) gastric emptying. When empty, there is (more/less) gastric emptying.
less
more
Why is there less gastric emptying when duodenum is full?
time for passage of content in duodenum
Reduced gastric motility/emptying is mediated by what 2 things?
- activation of SNS efferents
- deactivation of PSNS efferents
CCK released by what 2 stimuli?
lipids of 12-18 C atoms
amino acids
CCK is a _____ at the gastrin receptor.
partial agonist
If high gastrin concentration in blood, (increase/decrease) gastric motility by CCK. If low gastrin, (increase/decrease motility.
decrease
increase
GLP 1&2 release is stimulated by ____ in intestinal lumen.
CHO
GLP 1&2 lead to (increase/decreased) gastric motility mainly by GLP (1/2).
decreased
1
Order the following with how quickly of gastric emptying: (fastest to slowest)
low fat diets
high fat diets
liquid
liquid
low fat
high fat
Between meals (interdigestive period) _____ clears bulk from stomach to large intestine.
MMCs (migrating motor complexes)
Phase I MMCs
slow waves | no contraction
Phase II MMCs
intermittent spiking of slow waves (spike potentials)
Phase III MMCs
spikes at each crest of slow waves = train of peristaltic contractions
Which hormones provides neurocrine cholinergic action in Phase III of MMCs?
motilin
______ remains open to clear stomach during interdigestive period w/ MMCs.
pylorus
Phases of MMCs repeat every _____ and are immediately stopped by what?
2 hours
eating
Tetanic contractions after 24 - 72 hours after stomach empties are known as:
hunger pangs
Hunger contractions occur ______ hours after stomach empties by increasing phase ____ of MMCs.
12 -24
3
After 24 - 72 hours, intense rhythm of peristaltic contractions fuse into _____ contractions.
tetanic contractions